With open enrollment for Medicare Part D just around the corner, 50% discounts on brand name prescriptions while in the coverage gap seems to be a great new benefit this coming year… or is it? Some patient advocate groups, and we at PharmacyChecker.com, are asking, 50% off what price? Will PhRMA offer the discount on a higher-than-normal base price to cover their losses?

As the market, not the government, controls drug prices, it is a possibility that manufacturers will up the prices on drugs, especially specialty medications that lack brand-name alternative or generic competition, in order to make up for the lost profit. A brand name drug that costs $100 per month now – $50 in 2011 for Medicare Part D enrollees – may likely cost $120 next year – or $60 for Medicare enrollees – so that the manufacturers are able to spare revenue loss little by little.

And, brand name drug price increases may be discounted for Medicare enrollees, but what about the 51 million uninsured Americans? If price ratcheting happens, they may face the full brunt of drug company price increases, since they don’t receive the discount and will thus pay the full, upped price.

According to the Washington Post, drug company representatives say that premium increases and drug price adjustments ought to be seen as independent of the “doughnut hole” discounts to come. However, if “drug price adjustments” means higher prices then the bottom line is that the promised drug savings will be diluted.